Background: Drug resistance in Mycobacterium tuberculosis (MTB) is a major health issue worldwide. Recently,\nnext-generation sequencing (NGS) technology has begun to be used to detect resistance genes of MTB. We aimed\nto assess the clinical usefulness of Ion S5 NGS TB research panel for detecting MTB resistance in Korean tuberculosis\npatients.\nMethods: Mycobacterium tuberculosis with various drug resistance profiles including susceptible strains (N = 36)\nwere isolated from clinical specimens. Nucleic acids were extracted from inactivated culture medium and underwent\namplicon-based NGS to detect resistance variants in eight genes (gyrA, rpoB, pncA, katG, eis, rpsL, embB, and inhA).\nData from previous studies using the same panel were merged to yield pooled sensitivity and specificity values for\ndetecting drug resistance compared to phenotype-based methods.\nResults: The sequencing reactions were successful for all samples. A total of 24 variants were considered to be\nrelated to resistance, and 6 of them were novel. Agreement between the phenotypic and genotypic results was excellent\nfor isoniazid, rifampicin, and ethambutol, and was poor for streptomycin, amikacin, and kanamycin. The negative\npredictive values were greater than 97% for all drug classes, while the positive predictive values varied (44% to 100%).\nThere was a possibility that common mutations could not be detected owing to the low coverage.\nConclusions: We successfully applied NGS for genetic analysis of drug resistances in MTB, as well as for susceptible\nstrains. We obtained lists of polymorphisms and possible polymorphisms, which could be used as a guide for future\ntests applying NGS in mycobacteriology laboratories. When analyzing the results of NGS, coverage analysis of each\nsamples for each gene and benign polymorphisms not related to drug resistance should be considered.
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